Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PHARMACISTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources

The clinical pharmacist and research.

The question of whether or not clinical pharmacists are capable of performing meaningful research is addressed by reviewing the qualifications necessary for anyone to pursue an independent research career and by examining the current education and training of most clinical pharmacists. The types of research which appear to be best suited for clinical pharmacists include preclinical or clinical evaluations of basic science principles potentially affecting the therapeutic use of drugs in man, or the evaluation of clinical characteristics which alter the response to drugs in routine clinical use. It is concluded that clinical pharmacists with the appropriate postgraduate training and/or experience are capable of conducting meaningful research, and this is documented by current literature citations.

Drug Interactions↗

The role of the clinical pharmacist in medical education.

The clinical pharmacist is an integral member of the Docent team at the University of Missouri--Kansas City School of Medicine with duties in both teaching and patient care. These doctoral-level clinical pharmacists have sole responsibility for providing instruction in basic pharmacology and pharmacokinetics and for teaching pharmacotherapeutics to medical students and house officers at the Truman Medical Center. The pharmacology programs have been well received and are successful. Student evaluations have been positive, and acquisition of knowledge as measured by the computer-generated objective exam referred to as the Quarterly Profile Examination indicate progressive acquisition of basic pharmacologic information during periods of exposure to the clinical pharmacist. Analysis of part I of the National Boards of Medical Examiners Test shows that medical students with this instruction achieved higher scores in pharmacology than their mean performance on part I. House officers working with these clinical pharmacists also show progressive acquisition of basic pharmacologic knowledge as measured by the Quarterly Profile Exam. Preliminary evaluation of this nontraditional method of providing pharmacologic instruction indicates that the program is effective.

Education, Medical↗

Interview of patients by pharmacists contributes significantly to the identification of drug-related problems (DRPs).

PURPOSE: To investigate whether pharmacist interviews of hospitalised patients about their medication would result in identification of more drug-related problems (DRPs) than those found by usual care procedures and further to characterise the DRPs revealed at the interviews. METHODS: Patients from five internal medicine and two rheumatology departments in four hospitals in Norway were prospectively included in the study. Clinical pharmacists assessed DRPs by reviewing medical records and by participating in multidisciplinary team discussions. Drugs used, medical history, laboratory data and clinical/pharmacological risk factors were recorded (usual care procedure). A proportion of patients were randomly selected for interview with pharmacists. A quality team assessed the clinical significance of the DRPs. RESULTS: Seven hundred and twenty seven patients were included. Significantly more DRPs were found in the interview group (96 patients), an average of 4.4 DRPs per patient as compared to 2.4 DRPs in the non-interview group (631 patients) (p < 0.01). Of a total of 431 DRPs recorded in the interview group, 168 DRPs (39.9%) were disclosed through interviews. 'Need for additional drug', 'medical chart error', 'patient adherence' and 'need for patient education' were significantly more often recorded in this group. The quality team assessed 63% of the DRPs revealed in the interviews to be of major clinical significance. CONCLUSION: Significantly more DRPs were identified among the patients who were interviewed compared to those patients having only usual care examination. A high proportion of the DRPs identified in the interviews were of major clinical significance. The clinical pharmacists, with their way of interviewing, seem to fill a gap, ensuring that significant DRPs do not escape detection.

Adult↗

Recruitment of a cohort of lamotrigine users through community pharmacists: differences between patients who gave informed consent and those who did not.

OBJECTIVE: Community pharmacists may function as intermediaries in the recruitment of a population-based cohort of patients using specific drugs. In this study, baseline characteristics and the retention rate of patients that gave informed consent, refused and did not answer were compared. METHODS: A total of 1819 patients using the new antiepileptic drug (AED) lamotrigine were asked to provide informed consent for a retrospective chart study via their individual pharmacist. Four possible reactions resulted from the consent question: active consent, active refusal, passive refusal and non-informed. Patient characteristics and lamotrigine retention rate of the different groups were compared. RESULTS: Pharmacists did not inform a total of 183 patients (10%). Of the remaining patients, a total of 968 (59%) gave consent; 101 (6%) actively refused and 567 (35%) did not respond. Age, burden of illness, psychotropic co-medication and continuation of lamotrigine therapy were related to active consent. Lamotrigine retention rate in patients that gave consent was higher than in other patients. CONCLUSIONS: Patient recruitment with community pharmacists as intermediaries for observational studies on the effects of (new) drugs is feasible, and allows access to a broad population of patients. The recruitment procedure, however, may lead to selection bias.

Adolescent↗

Pharmacist-physician co-operation at a regional level.

In the Dutch region of "Betuwe" the hospital pharmacists and community pharmacists together provide short drug letters about new drugs, which are sent bimonthly to all the practising general practitioners (n = 83) and medical specialists (n = 50) in this region. A survey was conducted among these physicians in order to investigate their opinion about and reported use of the drug letters in comparison with other drug-information sources. The majority of the responding physicians (response rate 68%) was found to read the drug letter frequently and evaluated the drug letter as a useful source of information about drugs, especially its section about the advantages and disadvantages of the new drug compared to other drugs. With respect to the different stages of the drug-adoption process, the drug letter was found to be the most frequently used information source at the decision stage. At the introduction stage the pharmaceutical industry representative seems to be the most frequently used source of information, while at the information stage it is the "Geneesmiddelenbulletin" (Drug Bulletin). The majority of the responding general practitioners reported to participate in local group meetings with pharmacists. However, in only 20% of these group meetings attention is given to the drug letter. Since it is known that written information has only a limited influence on the physician's behaviour, the influence of the "Betuwe Circulaire" may increase when attention is paid to it in the local contacts between pharmacists and physicians.

Drug Information Services↗

Analysis of chromosomal aberrations, sister-chromatid exchanges and micronuclei in peripheral lymphocytes of pharmacists before and after working with cytostatic drugs.

The frequencies of chromosome aberrations, SCEs and micronuclei (cytokinesis-block method) in blood lymphocytes were compared among six nonsmoking female pharmacists before and after 1 year of working with cytostatic drugs. All possible precautions were taken to avoid exposure to cytostatics, including proper protective clothing and a monitored, negative-pressured working environment with vertical laminar flow cabinet. As referents, an age-matched group of six nonsmoking female hospital workers not dealing with cytostatics was simultaneously sampled twice with the same time interval. The pharmacists showed a marginally higher mean frequency of SCEs/cell (6.3; P = 0.049) after the working period than 1 year earlier (5.8). On the other hand, the referents, with no obvious exposure, had a higher mean number of cells with chromatid-type aberrations, gaps excluded, in the second sampling (2.0%; P = 0.048) than in the first one (0.5%). In addition, a slight (P = 0.055) trend towards a higher frequency of micronucleated binucleate cells was observed in the second sampling for both the exposed and control subjects. As such findings suggest technical variation in the cytogenetic parameters, the small difference observed in SCEs for the pharmacists between the two samplings was probably not related to the cytostatics exposure. No statistically significant differences were observed for any of the cytogenetic parameters in comparisons between the pharmacists and the referents. The findings suggest that caution should be exercised in comparing results obtained from two different samplings in prospective cytogenetic studies.

Adult↗

Positive benefits of a pharmacist-managed hypertension clinic in Nigeria.

OBJECTIVE: The aim of this study was to determine whether the provision of further practice-based support by pharmacists will bring about improved outcomes for blood pressure (BP) control in middle-aged and elderly Nigerian hypertensive patients managed with combination diuretics (amiloride hydrochloride 5 mg+hydrochlorothiazide 50 mg) and/or methyl dopa at the primary care level. DESIGN AND SETTING: This was a 1-year prospective, randomized cohort study of the outpatients of a state comprehensive health centre in South-western Nigeria. Free primary health services including free drugs were provided for all patients. PATIENTS AND METHOD: The study population comprised 51 Nigerian patients with uncomplicated hypertension aged 45 years or more, with a 0.2-3.0-year history of hypertension, registered at the Comprehensive Health Centre, Ife between October 2002 and March 2003. They were invited into the pharmacist-managed hypertension clinic and followed for the study period. Participating pharmacists counselled for current medication, personalized goals of lifestyle modification stressing weight loss and/or increased activity, increased patient awareness by providing relevant education about hypertension and associated/related diseases, adjusted drug therapy to optimize effectiveness and minimize adverse events, utilized treatment schedules that enhanced patients' adherence to therapy, and monitored treatment outcomes between enrollment and return visits. Patient satisfaction and the number of treatment failures within 6 months post enrollment were compared with retrospective data from our earlier study involving physician-managed patients under a similar setting. RESULTS: Uncontrolled BP reduced from 92 to 36.2% by 10.15+/-5.02 days after enrollment. Treatment failures were observed at 5.9% of the total return visits (n=184) within 6 months. CONCLUSION: Pharmacist-managed hypertension clinics can improve BP control, reduce treatment failure and increase patient satisfaction.

Aged↗

[Medication and pregnancy counseling, an incomfortable role for the retail pharmacists].

Tragedies subsequent to use of medication at the beginning of pregnancy have given rise to extreme distrust, placing the retail pharmacist in an uncomfortable situation. A survey of pharmacists in France has revealed that pregnant women ask for more information than any other patients, particularly when it comes to continuing medication started before pregnancy. In such cases, 57% of the polled pharmacists recommended discontinuation of the medication. Ninety percent thought they were sufficiently informed and massively recommended a prudent attitude. Their wish was to have an independent high-performance information tool available. There is such a tool: the Teratogenic Agent Information Center, rarely used by pharmacists. With the support of such a structure, 80% would be eager to take on more responsibilities in counseling patients and preventing teratogenic risks, in relation with other healthcare workers, thus guaranteeing high-quality medication counseling.

Adult↗

Pharmacist and nurse: a team approach towards primary health care or a convenient "therapeutic alliance"?

This paper explores the nature of the therapeutic alliance between nurses and community pharmacists in the South African context. To gain a better insight into the relatively new phenomenon, a combination of qualitative and quantitative methods was employed. The partnership developed in S.A. between the nurse and the pharmacist allows the pharmacists to "expand" their professional activities without "invading" the nurses' professional domain, and reaping substantial benefits in the process. These include potential increases in profits, enlarging the clientele base and improving the image of the pharmacy, by shifting the focus from a place of disease to a place of health, as well as creating the vision of the pharmacist as a team member in providing primary health care. As far as the nurses are concerned, it grants them the possibility to practice their profession in a very convenient set-up and affords them greater professional autonomy.

Humans↗

Pharmacists as nonprescription drug advisors.

This field study tested the ability of pharmacists to counsel patients with diabetes mellitus on the contraindicated use of a decongestant. The study was modeled after a 1969 study conducted by Knapp et al. Our simulation used a patient with diabetes who questioned pharmacists initially about proper insulin storage and then asked about the use of Contac (phenylpropanolamine) capsules, which carry a prominent label warning against use by diabetic patients. A research assistant, posing as the patient, interviewed pharmacists at 36 community pharmacies in a midwestern metropolitan area. Eleven of the pharmacists (30.5%) failed to warn the patient about the contraindication, compared with 83% in the earlier study.

Contraindications↗

Effects of frequency and similarity neighborhoods on pharmacists' visual perception of drug names.

To minimize drug name confusion errors, regulators, drug companies, and clinicians need tools that help them predict which names are most likely to be involved in confusions. Two experiments, carried out in the United States, examined the effects of stimulus frequency (i.e., how frequently a target name is prescribed), neighborhood frequency (i.e., how frequently prescribed are the "neighbors" of the target name), and neighborhood density (how many names are within a fixed distance of the target name) on the probability of pharmacists making an error in a visual perceptual identification task. In both experiments, the task was to correctly identify a series of blurry drug names after a 3s presentation on a computer monitor. In the first experiment, 45 pharmacists viewed 160 typewritten names, incorrectly identifying 60.6% of them. Random effects regression revealed a significant beneficial effect of stimulus frequency and a detrimental effect of neighborhood density. Significant two-way interactions were observed between stimulus frequency and neighborhood density and neighborhood frequency and neighborhood density. In the second experiment, 37 pharmacists viewed 156 handwritten drug names, incorrectly identifying 45.7%. Random effects regression revealed significant main effects of stimulus frequency and neighborhood density. These were contained within a significant three-way interaction: The interaction between stimulus frequency and neighborhood density was present at high but not low neighborhood frequency. Objectively measurable frequency and neighborhood characteristics have predictable effects on errors in pharmacists' visual perception. Organizations that coin and evaluate drug names, as well as hospitals, pharmacies, and health systems, should consider these characteristics when assessing visually confusing names.

Decision Making↗

Knowledge and beliefs of primary care physicians, pharmacists, and parents on antibiotic use for the pediatric common cold.

The aim of this study is to investigate knowledge and beliefs of primary care physicians (e.g. family practitioners and pediatricians), pharmacists, and parents regarding the use of antibiotics for the pediatric common cold, using a self-administered questionnaire for physicians and pharmacists and a telephone interview for parents. This article suggests that parents' expectation for antibiotics is a minor factor, and health care providers' unfounded beliefs in the effectiveness of antibiotics and exaggeration of parents' demand for antibiotics may be the major contributing factor underlying antibiotic over-prescription for the pediatric common cold in Korea. Most physicians and pharmacists knew the correct cause of the pediatric common cold, but majorities of the physicians and pharmacists believed that antibiotics could treat and reduce its complications. On the other hand, 34% of the parents believed that antibiotics could prevent complications. Seventy three per cent of the physicians reported that they perceived expectations for antibiotics from parents, but only 2% of the parents reported asking their physicians for antibiotics. In summary, this study suggests that physicians' knowledge and faulty beliefs can be more important factors for inappropriate antibiotic prescription.

Anti-Bacterial Agents↗

Pharmacists' evaluation of key communication skills in practice.

This paper reports the results of a major research initiative into the identification of key communication skills in community pharmacist-patient consultations. It is now widely accepted that the quality of practitioner-patient communication is fundamental to effective health care. However, an analysis of the literature pertaining to the communication issues facing health professionals in general and pharmacists in particular emphasised the need for more empirical research, to chart what pharmacists themselves deemed to be the nature and range of skills which contribute to effective communication performance in community pharmacy practice. The main aim of this research investigation was, therefore, to identify what constituted effective communicative performance by community pharmacists. This paper provides full details of the repertoire of skills and sub-skills identified as being the core communicative elements of practice. The results of this research will have relevance for health professionals and behavioural scientists, and will also contribute to the assurance of quality within the field of community pharmacy practice.

Adult↗

[Collaboration between general practitioners and pharmacists in the management of patients on high-dosage buprenorphine treatment. Prescribers' practices].

OBJECTIVES: This paper examines the collaboration between general practitioners (GPs) and pharmacists in the outpatient management of patients on high-dosage buprenorphine (HDB) treatment. METHODS: A telephone survey of a sample of HDB prescribers in southeastern France questioned them about their knowledge, practices, and opinions about HDB treatment in October 2002; data from the national health insurance fund and the national statistics institute completed the study. Logistic regression was used to investigate factors associated with collaboration with pharmacists. GPs' practices were compared to assess their correlation, if any, with this collaboration. RESULTS: 345 GPs participated in the study. Only 54% reported collaborating with dispensing pharmacists in managing patients on HDB, despite official guidelines encouraging it. Collaboration was independently related to training in addiction treatment, a favorable opinion of maintenance treatment by GPs, long experience in HDB prescription, and participation in a specialized medical network. CONCLUSION: Implementation of recommendations on physician-pharmacist collaboration requires additional training in addiction medicine for GPs and the encouragement of their participation in medical networks. On the other hand, increasing the constraints on GPs may negatively affect patients' access to care.

Adult↗

Impact of coaching by community pharmacists on drug attitude of depressive primary care patients and acceptability to patients; a randomized controlled trial.

OBJECTIVE: To investigate whether an intervention by Dutch community pharmacists improves the drug attitude of depressive patients, who are prescribed a nontricyclic antidepressant by their general practitioner (GP). METHOD: A randomized controlled trial with a 3-month follow-up was conducted among consecutive general practice patients who go to 19 pharmacists for antidepressants. The trial consisted of a control group (n=79) that received usual care and an intervention group (n=69) that received three drug coaching contacts at the pharmacy and a 25-min take-home video on the background of depression and the effects of medication. OUTCOME MEASURE: Drug attitude (DAI). RESULTS: At the baseline measurement there were no significant differences between the intervention and control group on any demographic and health status variables or on clinical symptoms. At the 3-month follow-up intervention patients had a better drug attitude (P=0.03) than their controls and evaluated the coaching of their pharmacist as more positive. They also felt the video to be useful. It had changed their ideas about medication. CONCLUSIONS: Coaching by community pharmacists is an effective way to improve drug attitude of depressive primary care patients and it is acceptable to them.

Adult↗

Pharmacists' beliefs about abortion and RU-486.

The author conducted a survey of pharmacists' beliefs regarding abortion and mifepristone (RU-486) to determine pharmacists' perceptions of the ethical dilemmas posed by the use of abortifacients in the United States and to determine whether and how these ethical dilemmas affect practice. The sample was nonrandom and included religiously oriented pharmacists from a variety of practice settings, approximately two-thirds of whom were women. The results indicated a plurality of beliefs about abortion rarely evident in the public debate. Although the sample supported pharmacists' right to refuse to dispense abortifacients, slightly more than half (51%) of the respondents stated that they themselves would not refuse to dispense abortifacients. Most respondents (56%) believed that abortion should remain a legal option, with slightly fewer respondents (50%) supporting the position that RU-486 should be made available in the United States. Support for abortion was proportionate to the gravity of the reason underlying the decision to abort, with the sample tending to avoid absolutistic positions. These findings tend to dispel the stereotypes and myths regarding abortion beliefs in that two-thirds of the sample were Catholic and 96% of the sample rated religion as extremely or somewhat significant in their life.

Abortifacient Agents, Steroidal↗

Career commitment: a mediator of the effects of job stress on pharmacists' work-related attitudes.

OBJECTIVE: The hypothesis for this study was that career commitment mediates the effects of job stress on several work-related attitudes of pharmacists. The effects of job stress, career commitment, met expectations, job satisfaction, and organizational commitment on job turnover intention were also investigated. DESIGN: Cross-sectional mail survey. SETTING: Nationwide sample of licensed pharmacy practitioners in the United States. PARTICIPANTS: 1,088 respondents (full- or part-time chain, independent, or hospital pharmacists) to a previous study. MAIN OUTCOME MEASURES: Rating scales measured each of the study variables. Demographic information was also collected. Data analyses included descriptive statistics, confirmatory factor analysis, and structural equation modeling with latent variables. INTERVENTIONS: None. RESULTS: Responses were received from 653 pharmacists out of 921 contacted (71%). The effects of job stress on job turnover intention were mediated through career commitment, met expectations, organizational commitment, and job satisfaction. Career commitment positively affected met expectations (beta = 0.35), and met expectations positively affected organizational commitment (beta = 0.66) and job satisfaction (beta = 0.78). An increase in the mean level of job satisfaction and organizational commitment decreased the likelihood of job turnover intention. Independent pharmacy owners tended to have the most positive attitudes toward work. CONCLUSION: Strategies should be developed to increase the career commitment of pharmacists. Increased commitment can reduce the negative effects of job stress and improve work-related attitudes.

Attitude of Health Personnel↗

Asthma patients' satisfaction with the frequency and content of pharmacist counseling.

OBJECTIVE: To assess the level of expectation and satisfaction of patients with asthma regarding the counseling provided by community pharmacists, and to identify the counseling information patients consider important in helping them manage their asthma. DESIGN: Mailed survey. PARTICIPANTS: 208 patients seen in the University of Utah Asthma Clinic for at least 3 months, age 18 years or older, and on at least 1 asthma medication. MAIN OUTCOME MEASURES: Frequency of pharmacist-provided asthma medication counseling, patients' perception of the importance of counseling, and their satisfaction with counseling. RESULTS: Response rate was 55% (106 of 194 surveys returned). The majority of patients (> 90%) indicated that their community pharmacist "never" or "sometimes" discussed the management of their asthma with them. Frequency of counseling in three predefined areas of asthma education (role of medications, inhaler technique, and prevention of asthma attacks) was 1.91, 1.72, and 1.31, respectively (1 = never, 4 = always). Most patients (76%) considered these areas of counseling to be important for the management of their asthma. Most patients (62%) were "somewhat" to "pretty" satisfied with the type and amount of asthma counseling provided by their pharmacist. Counseling sessions averaged less than 3 minutes. Only 25% of patients would be willing to pay an additional amount for pharmaceutical care. CONCLUSION: Self-reported rates of patient counseling concerning asthma medications in the community pharmacy setting are low and adequately address neither the educational needs of patients nor the recommendations of the National Asthma Education and Prevention Program.

Adult↗